距骨周围脱位29例临床治疗体会  

Clinical Treatment of 29Patients with Peritalar Dislocation

作　　者：马骁[1] 刘成[1] 李丹[1] 田勇[1] 刘守应[1] 

机构地区：[1]解放军253医院骨科,呼和浩特010051

出　　处：《解放军医药杂志》2012年第10期26-28,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：内蒙古自治区自然科学基金资助项目(200508010908)

摘　　要：目的探讨距骨周围脱位的治疗方法。方法选择2001年1月—2010年12月收治的距骨周围脱位29例,其中内侧型24例,外侧型5例。25例闭合脱位者中20例行闭合手法牵引复位,其余5例在腰硬联合麻醉下行切开复位。开放性脱位4例在硬膜外麻醉下切开复位。结果本组均获随访,随访时间12～22个月,平均(17.5±4.0)个月。根据美国足踝外科协会(AOFAS)后足功能评分标准评价疗效:优15例,良9例,可5例,优良率为82.76%。发生跗骨窦综合征4例,经局部治疗后缓解。距下关节骨性关节病2例,足底皮肤感觉减退1例,均未予处理。结论距骨周围脱位应早期明确诊断,视伤情经闭合手法复位或切开复位均可获得较满意疗效。Objective To explore the treatments of peritalar dislocation.Methods 29 patients with peritalar dislocation during January 2001 and January 2010 were treated.There were medial peritalar dislocation in 24 patients and the lateral peritalar dislocation in 5 patients.Among the 25 patients with closed dislocation,20 patients were treated with traction reduction by clogging method and and 5 with open reduction under the combined anesthesia of infantile waist stiffness.The rest 4 patients with open dislocation were treated with open reduction under the epidural anesthesia.Results All patients were followed-up for 12-22 months [averag（17.5±4.0） months].The joint function was assessed by AOFAS hindfoot criteria： there were excellent in 15 patients,good in 9 and common in 5,the fineness rate was 82.76%.There were 4 patients with sinus tarsi syndrome,who got relieved after local treatment.There were 2 patients with osteoarthrosis in subtalar joint and 1 with subdued plantar cutaneous sensation,who were all ignored.Conclusion The early definite diagnosis and active treatment is needed.The close manipulative reduction or open reduction is an effective surgical method for the treatment of peritalar dislocation.

关 键 词：距下关节 脱位 骨牵引复位法 手术 

分 类 号：R684.79[医药卫生—骨科学]